| NPI | 1922485317 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019032513) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS041192) |
| Enumeration Date | 2015-05-05 |
| Last Update Date | 2024-05-16 |